ABSTRACT
BACKGROUND: Health literacy is a determinant, powerful predictor of health. The Newest Vital Sign test (NVS) evaluates health literacy assessing the capacity of participants to understand the nutrition information label of an ice cream. AIM: To validate The NVS test for its application in the sociocultural context on primary care patients in Chile. MATERIAL AND METHODS: In a descriptive cross-sectional study, 1,117 people aged 58 ± 14 years (70% women) registered in the Cardiovascular Health Program of different Family Health Centers, answered the NVS test. They also answered the Test of Functional Health Literacy for Adults (TOFHLA) and the Health Literacy Survey, European Union (HLS-EU-32). An exploratory analysis was carried out. In addition, the Kuder-Richarson-20 reliability coefficient and Item-Test Point Biserial Correlations were calculated. The construct validity of the NVS was obtained using the Item Response Theory. The sensitivity and specificity of NVS were estimated using receiver operating characteristic curves using the TOFHLA score as gold standard. To establish the cutoff points, the Stratum-Specific Likelihood Ratio analysis was used. RESULTS: The reliability of the test was adequate (KR-20 = 0.7478) and the values of the two logistic parameters model confirmed that the NVS items account for the health literacy construct. Conclusions: The NVS test turned out to be a valid and reliable instrument, and its application is recommended to measure the level of health literacy.
Subject(s)
Humans , Health Literacy , Primary Health Care , Surveys and Questionnaires , Delivery of Health Care , Vital SignsSubject(s)
Health Literacy , Humans , Surveys and Questionnaires , Primary Health Care , Delivery of Health Care , Vital SignsABSTRACT
OBJECTIVE: To study the adherence of an Early Inpatient Exercise Program in patients with acute hip fracture, identify variables associated with its performance, and its association to one-year survival. METHODS: Observational longitudinal study of a cohort of 509 patients, admitted consecutively with a hip fracture in La Paz University Hospital (Madrid, Spain). Data included sociodemographic variables, pre-fracture physical functioning, cognitive impairment, comorbidities, measure of exercise adherence (pre-surgery exercise, post-surgery exercise, and rehabilitation sessions) and vital status at follow-up. One year after the fracture, either patients or relatives were contacted by telephone to ascertain their vital status. Data were analyzed using logistic regressions and multivariate Cox proportional hazards regression. RESULTS: Three quarters of patients (76.0%) were able to comply with the Early Inpatient Exercise Program. Factors associated with adherence were: living at home (Odds Ratio (OR)=3.39; 95% Confidence Interval (CI): 2.03, 5.64), absence of pre-fracture disability (OR=3.78; 95% CI: 2.21, 6.47), absence of pre-fracture cognitive impairment (OR=2.36; 95% CI: 1.36, 4.07) and comorbidities (OR=1.66; 95% CI: 1.03, 2.67). Early Inpatient Exercise Program adherence was associated with one-year survival (HR=1.62; 95% CI: 1.06, 2.49). CONCLUSIONS: The adherence with an Early Inpatient Exercise Program is high and is associated with 1-year survival. It is important to make a stronger effort to encourage participation in Early Inpatient Exercise Program in the 24% currently non-compliant, and in those with cognitive and physical impairments.
Subject(s)
Cognitive Dysfunction/physiopathology , Hip Fractures/rehabilitation , Activities of Daily Living , Exercise , Exercise Therapy , Hip Fractures/mortality , Hospitalization , Humans , Inpatients , Longitudinal Studies , SpainABSTRACT
Background Affordable interventions to improve metabolic control of Type 2-Diabetes Mellitus are increasingly necessary. Aim To review systematically the existing literature on the effects of psychological interventions on Type-2 Diabetes Mellitus compensation. Material and Methods We performed a systematic literature review and meta-analysis on the effectiveness of psychological interventions implemented for Type-2 Diabetes Mellitus patients. Research included the following electronic databases: PubMed, Bireme, Web of Science, SciELO, Embase, EBSCOhost, SCOPUS, Psychology Database. Results Most studies showed a decrease in the level of glycated hemoglobin after interventions, which applied different initiatives complementary to standard medical treatment. Mainly, these interventions encompassed training for self-monitoring and control of diabetes based on cognitive behavioral psychology, counseling, self-assessment and physical-spiritual work based on transpersonal psychology. Conclusions Psychological tools could be an adjunct to the standard medical treatment for patients with Type-2 Diabetes Mellitus, reducing glycated hemoglobin levels and improving self-regulation, disease awareness and adherence from the self-efficacy perception perspective.
Subject(s)
Humans , Psychotherapy/methods , Diabetes Mellitus, Type 2/psychology , Diabetes Mellitus, Type 2/therapyABSTRACT
Resumen El propósito de este trabajo fue estudiar la efectividad de intervenciones basadas en Mindfulness sobre el nivel de hemoglobina glicada —HbA1c— en pacientes con diabetes mellitus tipo 2 —DM2—. Se realizó una revisión sistemática e integración metanalítica preliminar. La búsqueda de los estudios se realizó en las siguientes bases: PubMed, Bireme, Web of Science, SciELO, Embase, EBSCOhost, SCOPUS, Psychology Database. Se identificaron 10 artículos: cuatro fueron llevados a cabo en Estados Unidos, dos en Irán, uno en Alemania, uno en Australia, uno en Tailandia y uno en Inglaterra. Se observó una reducción en los niveles de la HbA1c utilizando Mindfulness en comparación a los grupos controles (p < 0,02). Además, se observó un efecto diferenciado al analizar según número de participantes, sexo y tiempo de seguimiento. Se concluyó que el uso de intervenciones basadas en Mindfulness tendría un efecto indirecto sobre la reducción de la hemoglobina glicada.
Abstract The purpose of this paper was to study the effectiveness of Mindfulness-based interventions on the level of glycated hemoglobin —HbA1c— in patients with type 2 diabetes mellitus —DM2—. A systematic review and preliminary meta-analytic integration was performed. The search of the studies was carried out in the following bases: PubMed, Bireme, Web of Science, SciELO, Embase, EBSCOhost, SCOPUS, Psychology Database. Ten articles were identified: four were published in the United States, two in Iran, one in Germany, one in Australia, one in Thailand and one in England. A reduction in HbA1c levels was observed using Mindfulness compared to control groups (p <0,02). In addition, according to the number of participants, sex and time of follow-up a differentiated effect was found. It was concluded that the use of interventions based on Mindfulness would have an indirect effect on the reduction of glycated hemoglobin (HbA1c).
Subject(s)
Humans , Diabetes Mellitus, Type 2/psychology , Diabetes Mellitus, Type 2/therapy , Mindfulness , Glycated Hemoglobin/analysis , Treatment OutcomeABSTRACT
Background Affordable interventions to improve metabolic control of Type 2-Diabetes Mellitus are increasingly necessary. Aim To review systematically the existing literature on the effects of psychological interventions on Type-2 Diabetes Mellitus compensation. Material and Methods We performed a systematic literature review and meta-analysis on the effectiveness of psychological interventions implemented for Type-2 Diabetes Mellitus patients. Research included the following electronic databases: PubMed, Bireme, Web of Science, SciELO, Embase, EBSCOhost, SCOPUS, Psychology Database. Results Most studies showed a decrease in the level of glycated hemoglobin after interventions, which applied different initiatives complementary to standard medical treatment. Mainly, these interventions encompassed training for self-monitoring and control of diabetes based on cognitive behavioral psychology, counseling, self-assessment and physical-spiritual work based on transpersonal psychology. Conclusions Psychological tools could be an adjunct to the standard medical treatment for patients with Type-2 Diabetes Mellitus, reducing glycated hemoglobin levels and improving self-regulation, disease awareness and adherence from the self-efficacy perception perspective.